Healthcare Provider Details

I. General information

NPI: 1306736244
Provider Name (Legal Business Name): CAVALIER HEALTHCARE OF RED BAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 10TH AVE NW
RED BAY AL
35582-3800
US

IV. Provider business mailing address

106 10TH AVE NW
RED BAY AL
35582-3800
US

V. Phone/Fax

Practice location:
  • Phone: 256-356-4982
  • Fax:
Mailing address:
  • Phone: 256-356-4982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRIEN B HUBBARD
Title or Position: MANAGING MEMBER
Credential:
Phone: 601-503-6310